Reflux

The commonest disorder of the oesophagus is stomach contents coming back up from the stomach. This regurgitation is called reflux and is most often due to a hiatus hernia, where the upper part of the stomach pushes up into the chest cavity through an enlarged oesophageal gap, resulting in the stomach contents spilling up into the oesophagus.

COMMON SYMPTOMS

a sensation of having a lump in your throat

heartburn

pain behind the breast bone

chest pain that is not due to the heart

hoarse voice

chronic cough, particularly when straining and in a lying position

INITIAL TREATMENT INVOLVES LIFESTYLE CHANGES

Reflux is initially treated through lifestyle changes and with medication. But sometimes this does not help and surgery is necessary.
A gastroscopy, i.e. endoscopy of the stomach, is performed prior to any surgery. Read more about gastroscopy.

PROCEDURE

Surgery to treat a hiatus hernia is performed under general anaesthetic and normally using the keyhole method. In order to guarantee good visibility, the abdominal cavity is filled with carbon dioxide gas. The instruments are inserted through the abdominal wall via small cuts in the skin. In order to prevent stomach contents being regurgitated, the upper part of the stomach is rolled like a cuff around the lower part of the oesophagus. The oesophageal gap can also be made smaller at the same time. The surgery is conducted by two experienced surgeons.

AFTERCARE

The day after the operation, the patient can drink normally and they can eat soft food the day after that. Depending on their general condition, the patient is able to go home on either the first or second day after the operation.
Difficulties with swallowing are common following the surgery and may continue for anything from a few days to a couple of months. That is why it is very important for the patient to eat calmley at mealtimes and chew their food well.

It is normal for the stomach to swell following the surgery. The best way to deal with the swelling is to move about. Pain in the shoulder is common in the first few days. This pain is due to irritation from the harmless carbon dioxide that was put into the abdominal cavity during the operation.

Stitches that dissolve themselves do not need to be removed. The stitches dissolve about 10 days after the surgery.
The patient takes about two to four weeks off work after keyhole surgery and about two to four weeks after open surgery. During the period off work, it is beneficial to avoid strenuous exertion, but walks and gentle exercise is recommended.